RK, help me understand here...if things are working "OK" using the Tam or whatever drug is helping you pee with a reasonable flow, is surgery always necessary at some point?
Also, is your PSA test level indicative of a future problem requiring surgery? My PSA reading has always been less than 1.0 for example.
Rookie here trying to understand what's important.
I'll try.
The Tamsulosin was prescribed to help the kidney stones, which I seem to produce every couple of years, pass more easily thru the ureters which connect the kidneys and bladder. Several posters here report that streams are larger with the drug and that makes sense given how the drug works.
Ths Finesteride was prescribed to shrink my enormous prostate and if the earlier estimates were corrrect (300 and 356-grams) that drug did it's job as the prostate has shrunk to 263-grams according to my last MRI.
Why am I having surgery? Why have I been wearing this catheter for 6-weeks? Because my prostate is pushing against and even into the bladder causing bleeding. Lots of bleeding. I was admitted to the hospital after two ER visits within 12-hours, the first because I expelled lots and lots of blood when I went to the head and the second because the catheter I received in the first visit became blocked by blood clots. I had a procedure that emptied the bladder of blood and blood clots and the surgeon also cauterized any open bleeders in the bladder. I spent the next two nights in thr hospital for observation.
When I was discharged the doc have me a choice...remove the catheter and be back in the ER within 12-hours with more bleeding or keep it in and drink as much water and other liquids as I could tolerate to keep the 'line' open and allow the bladder bleeders to heal. Even so I was back in the ER twice more...#3 for another blood clot blockage. ER visit #4 turned out to be a false alarm as by then I was hyper sensitive to blockages.
Those first 10-15 days were pure agony and while it's better now it's still a PITA. I'm lucky if I get 4-hrs of actual sleep before waking up between 2a-4a. Empty the night bag and then back in the recliner (the bed is too uncomfortable). Another hour or two of sleep between 4 and 9a. At 9a I change bags to the daytime leg bag which I'll empty every 60-90 minutes. A change of clothes and a shower and my day starts.
It's too uncomfortable to drive so I bum rides from friends and neighbors. If I don't adjust the leg bag and exposed tubing just right I feel pain when moving in certain ways. Because of the catheter sitting on the head becomes a...process. 'Nuff said. Around 10 I switch back to the night bag amd watch TV from my recliner till midnight or so. Rinse and repeat.
My options are...remove the catheter and live at the ER; keep the catheter...forever, replacing it every 30-days: prostate surgery to reduce the size of the prostate and have a good shot at never seeing the inside of an ER again. At least not for this issue. EZ choice.
If you read this thread from the start you'll see more details. I could've dealt with this 2-yrs ago but chose not to. Lots of reasons but they all amount to procrastination. Don't know your circumstances but listen to your doc. If you feel the need get a second opinion...I did and that helped me decide which of two surgeries to have. I'm nervous but objectively comfortable with my choice.
You ask if surgery is ALWAYS necessary. Two reasons for surgery...cancer and my situation. Even with prostate cancer I'm told you're more likely to pass from something else as prostate cancer is a slow growing cancer. But if your prostate IS growing or gets huge like mine you may find yourself facing the same situation and choices I had.
Best advice to you and all the other men reading this...starting at age 40...50 for sure, have your prostate examimed every year. The PSA test does not tell the whole story. The exam is done one of two ways...the "snap" of a rubber glove on the doc's hand or by undergoing an MRI. I'd hate to hear of anyone else going thru what I'm dealing with.
Thanks to you all for well wishes, prayers, good thoughts and support.